Additional Value of SPECT/CT to Tc-99m MAG3 Renal Scintigraphy in the Diagnosis of a Patient with Ureteroileal Fistula

摘要

We performed Tc-99m MAG3 dynamic renal scintigraphy followed by a SPECT/CT imaging to a 38-yr-old woman who had a fistula in the lower urinary tract after a gynecological operation for diagnostic purposes. After scintigraphy, CT and fusion images were evaluated, it was observed that the activity in the right lower quadrant was actually in the ileal lumen. When early and late SPECT/CT images were compared, it was seen that the activity was moving distally with intestinal peristaltism. The reason for diagnostic imaging of the fistulas is not only to show the existence of the fistula but also locate it anatomically before the surgery. SPECT systems integrated with CT scanning provide functional and anatomical imaging at the same session. Dynamic renal scintigraphy and abdominal SPECT/CT, is a safe diagnostic procedure in visualization of urinary tract fistulas with advantages of the low cost, low radiation exposure and easier tolerability compared to double contrast imaging.